WBR0432
| Author | [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Alison Leibowitz)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Neurology |
| Prompt | [[Prompt::An 82-year-old male presents to the physician's office for insomnia. Following evaluation, you prescribe a benzodiazepine (BZD) to treat the patient’s condition. Several days later, the patient returns with complaints of frequent falls, impaired balance and coordination, and dizziness. Which of the following medications was most likely prescribed to treat this patient’s insomnia?]] |
| Answer A | AnswerA::Diazepam |
| Answer A Explanation | [[AnswerAExp::Diazepam, a long-acting BZD, has side effects such as falling, dizziness, and impaired balance and coordination.]] |
| Answer B | AnswerB::Alprazolam |
| Answer B Explanation | [[AnswerBExp::Alprazolam is a short-acting BZD.]] |
| Answer C | AnswerC::Triazolam |
| Answer C Explanation | [[AnswerCExp::Triazolam is a short-acting BZD.]] |
| Answer D | AnswerD::Oxazepam |
| Answer D Explanation | [[AnswerDExp::Oxazepam is a short-acting BZD.]] |
| Answer E | AnswerE::Midazolam |
| Answer E Explanation | [[AnswerEExp::Midazolam is a short-acting BZD.]] |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::The patient is most likely prescribed a long-acting BZD. Side effects of long-acting BZDs are frequent falls, impaired balance and coordination, and dizziness especially in the elderly population. In contrast, short-acting BZDs have the worst addiction potential.
Long-acting BZDs include: Diazepam, clonazepam, nitrazepam, and flurazepam.
Short-acting BZDs include: Alprazolam, triazolam, oxazepam, and midazolam. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::benzodiazepine, WBRKeyword::diazepam, WBRKeyword::side effect, WBRKeyword::falling, WBRKeyword::elderly, WBRKeyword::dizziness, WBRKeyword::balance, WBRKeyword::long acting, WBRKeyword::addictive, WBRKeyword::BZD |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |